Frontiers of Health Services Management - Summer 2014 - (Page 39)
lamenting high utilization to getting to
know our high utilizers. We are now making concerted efforts to integrate clinical
services, to focus on care coordination-
which includes coordinating the coordinators-and to partner with community and
governmental organizations in building
a network of care that historically would
have been considered outside the purview
of a hospital, much less healthcare in
general. this is a step toward the community health business model promoted by
Kindig and isham.
Accountable Care
Communities
A collaborative, integrated, and measurable
strategy that emphasizes shared responsibility for the health of the community, including
health promotion and disease prevention,
the national governors association
(2013) suggests that accs "take the concept of medical homes and accountable
care organizations one step further by
fostering collaborations borne of shared
responsibility among clinical and community sector participants to reform health
systems in particular localities." Kindig
and isham mention accs as one model
with the potential for addressing total
population health.
The Integrator Role
Kindig and isham appropriately highlight
the importance of an "integrator," an organization that will pull together the various
clinical and social services. Whether we
like it or not, given our community presence, hospitals and healthcare organizations will be at the center of these population health dynamics. and even if we
account for only 20 percent of health outcomes, we may always be expected by our
communities and by business and government sectors to provide central leadership and do the population health "heavy
lifting." that expectation will require that
we play a role in both clinical and social
initiatives. finding the appropriate mix
between the two will be a challenge for
any provider. the HealthPartners example
featured by Kindig and isham and similar
initiatives will be rare examples indeed
unless and until payment models support
this kind of work. But it is possible. as a
point of reference, the actuarial analysis
conducted for our cMMi proposal forecasted a reduction in Medicaid spending
C hr is t op he r Da dl e z , FAC H E * 39
C o m m e n t a r y
Some of our efforts reflect a move toward
an accountable care community (acc)
model that bridges clinical and community
settings to address both the medical and
the social needs of high-risk, high-cost, or
vulnerable patients in an integrated manner consistent with the triple aim. in fact,
we partnered with community Solutions
and the Department of Mental Health and
addiction Services in connecticut-as
well as with nuHealth, the Health and
Welfare council of long island (nY), and
Health leads on long island-to submit a
proposal to cMS's center for Medicare &
Medicaid innovation (cMMi) for developing accs in Hartford county and nassau
county.
Accountable care community is a term
that was first employed by the austen Bioinnovation institute in akron (aBia) to
describe a multisector, community-based
collaborative effort to transform healthcare in northeast ohio. the aBia (2012)
defines an acc as
access to quality services, and healthcare delivery. . . . It builds on initiatives to encompass
not only the area's medical care providers, but
also the public health system and community
stakeholders whose work, taken together, spans
the spectrum of the determinants of health.
Table of Contents for the Digital Edition of Frontiers of Health Services Management - Summer 2014
Table of Contents
Frontiers of Health Services Management - Summer 2014
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